AB045. SOH26AB_0399. Factors influencing decision to recommend non-operative management in breast cancer patients with operable tumours: a single-centre 5-year review

Background: Frail and elderly patients with operable hormone receptor-positive breast cancers are often offered non-operative management in the form of hormonal therapy. There is wide variation in practice, and a paucity of guidelines on the clinical rationale and decision-making process in the management offered to this patient cohort. We aimed to evaluate current practice, analysing incidence, rationale to recommend non-operative management, and outcomes for this patient cohort.

Methods: A single-centre retrospective cohort study of all patients with non-metastatic disease who did not undergo surgery from 2015 to 2019 was performed using the prospectively collected Breast Cancer Registry. Registry data were supplemented with a targeted chart review.

Results: From 2015 to 2019, 198 breast cancer patients were managed non-operatively, with hormone manipulation therapy. The median age was 82 years. Documentation supporting the decision to recommend non-operative management was highly variable. No geriatric assessment tool or co-morbidity index was documented as an objective contributing factor in the decision process to offer non-operative management.

Conclusions: This study highlights the lack of evidence-based guidelines to support and direct the management of this patient cohort. Furthermore, it provides a strong basis to perform further prospective studies and to consider piloting the introduction of geriatric assessment tools to aid in improving the provision of personalised care to this elderly cohort.

Keywords: Breast cancer; elderly; frailty; hormone positive breast cancer; non-operative management